ABSTRACTBackground: European health care workers recently experienced serious challenges to their mental health. Following the extremely stressful experience of the COVID-19 pandemic, the war in Ukraine caused a humanitarian influx of refugees in need of social and healthcare. We aimed to explore: (1) how working with refugees has affected the mental well-being of health care workers in the context of the COVID-19 pandemic, and (2) the nature of health care workers' emotional strain related to the refugee situation and the war in Ukraine.Methods: We used a combination of quantitative regression analyses and qualitative content analysis to assess data collected by an online questionnaire in 2022. The study included 1121 health care workers from the Czech arm of the international HEROES Study.Results: Quantitative findings did not indicate that working with Ukrainian refugees was reliably associated with a greater occurrence of symptoms of depression, anxiety, distress, or burnout. Qualitative analysis revealed five categories of emotional strain: impacts on working conditions, emotional reactions to refugees and the war, comparisons with the COVID-19 pandemic, and coping strategies.Conclusions: This study highlights the resilience of health care workers but also points to the need for ongoing support to address the complex emotional challenges they face during health crises.
Although we did not find a significant association between working with refugees and mental health issues, health professionals encountered emotionally challenging situations.Emotionally challenging situations involved reactions to the war and refugees, worsening working conditions, and higher subjective strain than during the COVID-19 pandemic.When comparing health workers caring for with refugees and COVID-19 patients, we found differences in their mental health issues.
- Klíčová slova
- COVID-19 pandemic, Migración, Migration, Russian-Ukrainian war, emotional strain, guerra ruso-ucraniana, malestar psicológico, pandemia de COVID-19, psychological distress,
- MeSH
- adaptace psychologická MeSH
- COVID-19 * psychologie MeSH
- deprese psychologie epidemiologie MeSH
- dospělí MeSH
- duševní zdraví * MeSH
- lidé středního věku MeSH
- lidé MeSH
- pandemie MeSH
- profesionální vyhoření psychologie MeSH
- průzkumy a dotazníky MeSH
- psychický stres psychologie MeSH
- SARS-CoV-2 MeSH
- uprchlíci * psychologie statistika a číselné údaje MeSH
- úzkost psychologie MeSH
- zdravotnický personál * psychologie statistika a číselné údaje MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- Ukrajina MeSH
Human migration is an increasingly common phenomenon and migrants are at risk of disadvantageous treatment. We reasoned that migrants may receive differential treatment by locals based on the closeness of their facial features to the host average. Residents of Türkiye, the country with the largest number of refugees currently, served as participants. Because many of these refugees are of Arabic origin, we created target facial stimuli varying along the axis connecting Turkish and Arabic morphological prototypes (excluding skin colour) computed using geometric morphometrics and available databases. Participants made judgements of two universal dimensions of social perception-warmth and competence-on these faces. We predicted that participants judging faces manipulated towards the Turkish average would provide higher warmth and competence ratings compared to judging the same faces manipulated towards the Arabic average. Bayesian statistical tools were employed to estimate parameter values in multilevel models with intercorrelated varying effects. The findings did not support the prediction and revealed raters (as well as target faces) to be an important source of variation in social judgements. In the absence of simple cues (e.g. skin colour, group labels), the effect of facial morphology on social judgements may be much more complex than previously assumed.
- Klíčová slova
- face perception, facial morphology, geometric morphometrics, intergroup relations, stereotype content model, stereotyping,
- MeSH
- dospělí MeSH
- lidé MeSH
- mínění * fyziologie MeSH
- mladiství MeSH
- mladý dospělý MeSH
- rozpoznání obličeje * fyziologie MeSH
- sociální percepce * MeSH
- stereotypizace * MeSH
- uprchlíci psychologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Turecko etnologie MeSH
OBJECTIVES: The Russian military aggression against Ukraine in February 2022 became the cause of the biggest humanitarian crisis. Postpartum depression (PPD) is a type of mood disorder of pregnant and postpartum women. It was earlier reported that depression of pregnant women is increased in a combat zone, while effects of war on pregnant refugee and displaced women are less studied. The aim of the study was to determine the features of emotional state of temporarily displaced Ukrainian women who gave birth in Lithuania in spring-autumn 2022, and compare it with the state of Lithuanian women who were not directly affected by war. METHODS: The study was conducted by surveying a group of Ukrainian refugee women (UG) and a group of Lithuanian women (LG) who gave birth in maternity units of Lithuania, using Edinburgh Postpartum Depression Scale (EPDS), the questionnaire elaborated for evaluation of social and medical peculiarities of mother-child pair in early postpartum period as well as medical records of maternity unit. RESULTS: The average mean scores of EPDS in UG were significantly higher compared to LG; 42% of UG exceeded the threshold for the high risk of PPD (> 13). UG, who arrived in Lithuania during the war because of close relatives legally working in Lithuania, had lower EPDS scores to compare to UG who came from combat zones and who did not have close relatives. CONCLUSIONS: Support of closest relatives and convenient surrounding is important for women's emotional state during the vulnerable period of maternity and especially during the crisis time.
- Klíčová slova
- Edinburg Postpartum Depression Scale, Ukraine, pregnancy, refugees, war,
- MeSH
- dospělí MeSH
- lidé MeSH
- poporodní deprese * epidemiologie psychologie MeSH
- průzkumy a dotazníky MeSH
- těhotenství MeSH
- uprchlíci * psychologie statistika a číselné údaje MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Litva epidemiologie MeSH
- Ukrajina epidemiologie MeSH
Sri Lankan Tamil refugees (SLTRs) have lived in the United Kingdom in substantial numbers for about three decades. However, they remain under-represented in academic and public discourse, and little is known about their migration experiences. This study examined first-hand accounts of such experiences, with special attention paid to identity and acculturation. Data were collected through four semi-structured interviews and analysed using interpretative phenomenological analysis (IPA). The results suggest that SLTRs' experience of conflict as an imposed life disruption continues to shape their adaptation, identity, and meaning-making ("Afflicted life"). Changing social identities mediate protection from, as well as risk of, trauma. SLTRs try to remedy the socio-economic and emotional losses suffered in the conflict, but achieve only a partial compensation. Consequently their repair efforts are a source not only of positive emotions but also of dissatisfaction ("Living past"). Finally, participants' sense of belonging and quest for home represent a challenging socio-emotional process in which they continue to engage even decades after migration ("Continuing quest for home"). This nuanced analysis of how the past continues to shape lived experience, contributes to the under-developed literature on qualitative psychological investigations of acculturation, research on forced migration, and the establishment of IPA in social psychology.
- Klíčová slova
- Sri Lanka, UK, acculturation, identity, migration, qualitative study, refugees,
- MeSH
- akulturace * MeSH
- dospělí MeSH
- kvalitativní výzkum MeSH
- lidé středního věku MeSH
- lidé MeSH
- sociální identifikace * MeSH
- uprchlíci * psychologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Spojené království MeSH
- Srí Lanka etnologie MeSH
BACKGROUND: The Slovak Republic, an Eastern European country, borders Ukraine, which has one of the highest rates of HIV/AIDS in Europe. This study aims to inform readers about the demographic characteristics of Ukrainian war refugees with HIV/AIDS seeking temporary protection status in Slovakia due to the Russian invasion of February 24, 2022. It focuses on their epidemiology, immunological profiles, co-infections, and treatment. DESIGN: Multicenter, retrospective study between March 1, 2022, and March 31, 2023. METHODS: Data were collected from all Ukrainian patients with refugee status living with HIV or newly diagnosed, who presented to any of the five HIV/AIDS centers in Slovakia. Information was obtained through medical interviews, physical examinations, laboratory tests and medical reports from the Ukrainian Ministry of Health. RESULTS: From March 1, 2022, to March 31, 2023, 141 Ukrainian refugees were included, mostly women (56.7 %, n = 80), with a median age of 41 years. The median CD4+ count was 680 cells/mL; 69.2 % (n = 97) had a viral load below 40 copies/mL. On arrival, 87.8 % (n = 123) were on ART, 90.2 % (n = 111) on dolutegravir. Coinfections included hepatitis C (31 %, n = 41), hepatitis B (12.5 %, n = 17), and tuberculosis (11.3 %, n = 16). Three died from AIDS complications. CONCLUSION: The study provides a detailed overview of the epidemiological, demographic, immunological, co-infection, and treatment characteristics of Ukrainian PLWHA displaced by the war to the Slovak republic. With the conflict ongoing, it is necessary to be prepared for more refugees in the coming months.
- Klíčová slova
- AIDS, Antiretroviral therapy, HIV, Refugees, Slovakia, Ukraine,
- MeSH
- dospělí MeSH
- HIV infekce * epidemiologie farmakoterapie MeSH
- koinfekce epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- počet CD4 lymfocytů MeSH
- retrospektivní studie MeSH
- uprchlíci * statistika a číselné údaje MeSH
- virová nálož MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Geografické názvy
- Slovenská republika epidemiologie MeSH
- Ukrajina epidemiologie MeSH
INTRODUCTION: A growing body of research is examining how healthcare systems are responding to the increasing numbers of migrants and the resulting superdiversity of patients. The aim of this article is to identify and explain communication barriers in the provision of healthcare to Ukrainian war refugees in the Czech Republic from the perspectives of healthcare professionals and intercultural mediators. METHODS: The exploratory case study is based on a qualitative analysis of semi-structured interviews with frontline health professionals: 20 with doctors and 10 with nurses. The second source of data is two focus groups aimed at capturing communication problems from the perspective of intercultural mediators who accompany refugees to health facilities. The interview transcripts and FGs were analysed using six-stage thematic coding. RESULTS: The survey identified five main themes related to barriers to communication: (1) language barriers and interpreting, (2) cultural barriers, (3) differing expectations of health and the healthcare systems in the Czech Republic and Ukraine, (4) prejudices and negative attitudes and unethical behaviour towards refugees and migrants and (5) lack of awareness of patient rights. CONCLUSIONS: The arrival of large numbers of migrants has highlighted deficiencies in the system that may affect other vulnerable groups and the general population. These include the lack of general communication skills and legal awareness among many health professionals, which are barriers to the development of patient-centred care. The involvement of intercultural mediators fundamentally improves communication between health professionals and (not only) migrant patients. Nevertheless, it is necessary to legally anchor and define the position of intercultural mediators within the healthcare system. PATIENT OR PUBLIC CONTRIBUTION: Collaboration with intercultural mediators who interpreted the extensive experiences of Ukrainian refugee patients and also have personal experience as migrant or migrant-origin patients contributed to shaping research questions, facilitating study participation and enriching evidence interpretation. Researchers with multicultural backgrounds and experience with working with people from refugee backgrounds were involved in the study design and analysis.
- Klíčová slova
- Ukrainians, communication barriers, forced migration, health care, intercultural mediators,
- MeSH
- dospělí MeSH
- komunikace MeSH
- komunikační bariéry * MeSH
- kvalitativní výzkum MeSH
- lidé středního věku MeSH
- lidé MeSH
- poskytování zdravotní péče MeSH
- postoj zdravotnického personálu MeSH
- rozhovory jako téma MeSH
- uprchlíci * psychologie MeSH
- zdravotnický personál psychologie MeSH
- zjišťování skupinových postojů MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
- Ukrajina MeSH
BACKGROUND: Russia's military aggression against Ukraine set in motion a large number of refugees. Considerable amount of them came and stayed in Czechia. Refugees represent special vulnerable individuals often affected by war physically and psychologically. Due to the national regulations not allowing most of Ukrainian men aged 18-60 to leave the country, nowadays Ukrainian forced migration is relatively young and strongly gendered. Evidence suggests the higher probability for searching the safe refuge abroad among Ukrainian women with small children as well as those with relatively higher economic and cultural capital. The aim of this study is to identify the structural features of systemic risks associated with war migration by examining determinants of self-rated health among forcibly displaced highly educated Ukrainian women of productive age residing in Czechia. METHODS: Data from one wave of the panel survey among Ukrainian refugees in Czechia conducted in September 2022 was used. Determinants of self-rated health including self-reported diseases and healthcare factors, lifestyle, human and social capital, economic factors, and migration characteristics were analysed using binary logistic regression. RESULTS: About 45% highly educated Ukrainian women refugees in Czechia assessed their health as poor. The poor self-rated health was mostly associated with the number of diseases and depressive symptoms, and by social capital and economic factors. Having four and more diseases (OR = 13.26; 95%-CI: 5.61-31.35), showing some severe depressive symptoms (OR = 7.20; 95%-CI: 3.95-13.13), experiencing difficulties to seek help from others (OR = 2.25; 95%-CI: 1.20-4.23), living alone in a household (OR = 2.67; 95%-CI: 1.37-5.27), having severe material deprivation (OR = 2.70; 95%-CI: 1.35-5.41) and coming originally from the eastern part of Ukraine (OR = 2.96; 95%-CI: 1.34-6.55) increased the chance of these refugees to assess their health as poor. CONCLUSION: Social and economic determinants such as lack of social contacts for seeking help and material deprivation were found to be crucial for self-rated health and should be tackled via migration policies. Further, qualitative research is needed to better understand the mechanisms behind the factors affecting subjectively assessed health.
- Klíčová slova
- Czechia, Economic determinants, Social capital, Subjective health, Systemic risks, Ukraine, War refugees,
- MeSH
- charakteristiky rodiny MeSH
- dítě MeSH
- lidé MeSH
- průřezové studie MeSH
- socioekonomické faktory MeSH
- uprchlíci * MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
OBJECTIVE: Acute flaccid paralysis (AFP) is a major neurological problem. Turkey has accepted over 4 million refugees since 2011 due to the wars in neighbouring countries. In the long term, refugees can have adverse effects on the limited resources of health, sanitation, water supply, foodstuff, and shelter services of host countries, precipitating the transmission and spread of enteroviruses causing AFP. This study examines the 13-year surveillance and incidence of AFP cases in southeast Turkey, and questions possible impact of refugee movements on these parameters, comparing the periods before (2007-2010) and after (2011-2019) 2011, when the refugee movements emerged. METHODS: The records of cases reported from southeast part of Turkey with suspected AFP between January 2007 and December 2019 were reviewed retrospectively. RESULTS: Of the patients, 121 (58.5%) were male. Mean age was 80.36 ± 46.67 months. Eighty-five (41.1%) were aged 60 months or younger. The number of patients under 60 months increased significantly after 2011. Mean incidence was calculated as 0.88 cases/100,000 person years versus 1.58 cases/100,000 person years in the period before and after 2011, respectively. Guillain-Barré syndrome (GBS) was the most common cause of AFP in both periods. As of 2011, however, the incidence of acute transverse myelitis increased approximately 4 times and GBS decreased proportionally. Non-polio enteroviruses were the most frequent isolates, detected from 9.1% of stool samples. CONCLUSION: Although refugee movements appear to may have adverse effects on AFP incidence and surveillance outcomes, larger studies involving the whole country, particularly at places where no refugees settled, are needed to achieve more conclusive evidence.
- Klíčová slova
- acute flaccid paralysis, enterovirus, non-polio enterovirus, refugees, surveillance,
- MeSH
- dítě MeSH
- incidence MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- paralýza epidemiologie MeSH
- předškolní dítě MeSH
- retrospektivní studie MeSH
- surveillance populace MeSH
- uprchlíci * statistika a číselné údaje MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Turecko epidemiologie MeSH
BACKGROUND: The war in Ukraine has led to significant migration to neighboring countries, raising public health concerns. Notable tuberculosis (TB) incidence rates in Ukraine emphasize the immediate requirement to prioritize approaches that interrupt the spread and prevent new infections. METHODS: We conducted a prospective genomic surveillance study to assess migration's impact on TB epidemiology in the Czech Republic and Slovakia. Mycobacterium tuberculosis isolates from Ukrainian war refugees and migrants, collected from September 2021 to December 2022 were analyzed alongside 1574 isolates obtained from Ukraine, the Czech Republic, and Slovakia. RESULTS: Our study revealed alarming results, with historically the highest number of Ukrainian tuberculosis patients detected in the host countries. The increasing number of cases of multidrug-resistant TB, significantly linked with Beijing lineage 2.2.1 (p < 0.0001), also presents substantial obstacles to control endeavors. The genomic analysis identified the three highly related genomic clusters, indicating the recent TB transmission among migrant populations. The largest clusters comprised war refugees diagnosed in the Czech Republic, TB patients from various regions of Ukraine, and incarcerated individuals diagnosed with pulmonary TB specialized facility in the Kharkiv region, Ukraine, pointing to a national transmission sequence that has persisted for over 14 years. CONCLUSIONS: The data showed that most infections were likely the result of reactivation of latent disease or exposure to TB before migration rather than recent transmission occurring within the host country. However, close monitoring, appropriate treatment, careful surveillance, and social support are crucial in mitigating future risks, though there is currently no evidence of local transmission in EU countries.
- Klíčová slova
- Control of tuberculosis, Migration, Refugees, Tuberculosis epidemiology,
- MeSH
- dospělí MeSH
- incidence MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- molekulární epidemiologie * MeSH
- multirezistentní tuberkulóza epidemiologie MeSH
- Mycobacterium tuberculosis * genetika izolace a purifikace MeSH
- osoby s přechodným pobytem a migranti * statistika a číselné údaje MeSH
- ozbrojené konflikty MeSH
- prospektivní studie MeSH
- tuberkulóza * epidemiologie přenos MeSH
- uprchlíci * statistika a číselné údaje MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
- Slovenská republika epidemiologie MeSH
- Ukrajina epidemiologie MeSH
PURPOSE: To screen visual acuity in two refugee camps in Greece and explore the feasibility of replicating these methods on a nationwide scale. METHODS: Visual acuity was assessed in all participants using web-based Democritus Digital Acuity & Reading Test (DDART). Furthermore, the immigrants responded to a structured questionnaire regarding their demographics and medical history. RESULTS: A total of 330 adult refugees and immigrants were recruited. A total of 47.3% of the patients had never undergone ophthalmological examination. A significant negative correlation was detected between age (r = -0.207, p < 0.001) and educational background (r = -0.135, p = 0.014), suggesting that younger immigrants who had attended compulsory education were more likely to have their eyes checked in their home country. A total of 6.97% of patients presented with impaired vision and were referred for further care. All remote DDART measurements presented no differences from the corresponding hospital-based data in the referred cases. CONCLUSIONS: Visual acuity screening using DDART provides valuable information regarding the visual capacity of refugees. The study outcomes suggest that pilot methods can be replicated on a nationwide scale. CLINICAL TRIALS: Gov number NCT05209581; date of registration: January 13, 2022. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors have no funding or conflicts of interest to disclose. Patients Consent Statement: The patients sign written consent form.
- Klíčová slova
- DDART, immigrants, refugees, screening, visual acuity,
- MeSH
- dospělí MeSH
- emigranti a imigranti * MeSH
- internet MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- pilotní projekty MeSH
- průzkumy a dotazníky MeSH
- screening zrakových vad metody MeSH
- senioři MeSH
- uprchlíci * MeSH
- zraková ostrost * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Řecko MeSH
